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Routine Rehabilitation Versus Shock Wave Therapy for Scapular Dyskinesis

6. juni 2026 oppdatert av: Aliaa Mamdouh Abdelaziz Farag, Tanta University

Routine Rehabilitation Versus Shock Wave Therapy for Patients With Scapular Dyskinesis

It has been proposed that altered scapular muscle function can contribute to alterations in shoulder kinematics, which often lead to SD and are frequently associated with other shoulder pathologies, such as RC tears, labrum tears, impingement syndrome, and glenohumeral joint instability. However, whether SD leads to the development of these diseases or is a consequence has yet to be clarified. Changes in scapular kinematics can be attributed not only to altered scapular recruitment patterns (e.g., altered serratus anterior muscle activity) or muscle performance (e.g., force imbalance in the upper and lower trapezius muscles) but also to flexibility deficits in the soft tissue surrounding the scapula, which may restrict normal scapular movement during daily activities and sport- specific movements. Although many studies have investigated the optimal management method, to date, there is no consensus. Conservative approaches involve not only physiotherapy but also other techniques, such as extracorporeal shockwave therapy.

Studieoversikt

Detaljert beskrivelse

This is a prospective, double-blinded, placebo-controlled randomised study. The closed envelop randomization method will be used for the randomization of the patients who will be also blinded to group allocation. The patients will be allocated into two groups:Group I: will be exposed to rESWT once weekly for one month Group II: will be exposed to ShamrESWT once weekly for one month. During the study period, stretching exercises will be similarly given for both groups.

Studietype

Intervensjonell

Registrering (Antatt)

100

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

      • Tanta, Egypt
        • Rekruttering
        • Tanta University

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  • This study included 100 patients with scapular dyskinesis. The patients were divided into 2 groups: one group was treated with ESWT and routine rehabilitation, and the second group was treated with routine rehabilitation only. Adult patients with scapular dyskinesia who exhibited signs of dyskinesia for at least 6 months before enrolment in the study will be selected.

Exclusion Criteria:

  1. History of shoulder or thorax trauma or surgery.
  2. The back pain involved the cervical spine and thoracic spine.
  3. Participants with neurologic deficits
  4. history of inflammatory conditions such as ankylosing spondylitis

4- Certain situations where shockwave therapy is not recommended. These include:

Absolute contraindications:

  • Active infection (i.e., osteomyelitis)
  • Malignant tumors, particularly at the treatment site (focused shockwave)
  • Pregnancy

Relative Contraindications:

  • The brain or nerve in the treatment focus
  • Treatment focused on the lungs or pleura
  • Significant coagulopathy (increased risk of bleeding, such as haemophilia)
  • Epiphyseal plate in treatment focus

Important considerations:

  • Cardiac pacemakers or other implantable devices
  • Current nonsteroidal anti-inflammatory drug use
  • Current anticoagulation use
  • Recent corticosteroid injections (receiving a steroid injection into the area to be treated within the previous 12 weeks).

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Trippel

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: Radial extracorporeal shock wave therapy/ Intervention group
Radial extracorporeal shock wave therapy (r ESWT) will be applied by Dornier AR2 machine (DornierMedTech GmbH, Wessling, Germany) under ultrasound guidance, at periscapular muscles . 1.500 pulses will be applied by an R20 probe with a focusing depth of 4cm. The intensity will be 0.10 mJ to 0.3mJ/mm2 (2.5 bar), with frequency 4 Hz every week for one month for the treatment group and without operating the machine for the sham group . No anesthetic oranalgesic drugs will be administered to patients during the therapy session. Both groups will be put under the same physiotherapeutic program performed by the same well-trained physiatrist.
Radial extracorporeal shock wave therapy (r ESWT) will be applied by Dornier AR2 machine (DornierMedTech GmbH, Wessling, Germany) under ultrasound guidance, at periscapular muscles . 1.500 pulses will be applied by an R20 probe with a focusing depth of 4cm. The intensity will be 0.10 mJ to 0.3mJ/mm2 (2.5 bar), with frequency 4 Hz every week for one month for the treatment group and without operating the machine for the sham group . No anesthetic oranalgesic drugs will be administered to patients during the therapy session. Both groups will be put under the same physiotherapeutic program performed by the same well-trained physiatrist.
Sham-komparator: Sham rESWT/ Control group
Sham rESWT once weekly for one month. The Dornier AR2 machine (Dornier MedTechGmbH, Wessling, Germany) used under ultrasound guidance, at affested periscapular muscles . 1.500 pulses will be applied by anR20 probe with intensity of 0.10 mJ to0.3mJ/mm2 (2.5 bar) & frequency 4 Hz every week for one month without operating the machine.
The Dornier AR2 machine (Dornier MedTechGmbH, Wessling, Germany) used under ultrasound guidance, at affested periscapular muscles . 1.500 pulses will be applied by anR20 probe with intensity of 0.10 mJ to0.3mJ/mm2 (2.5 bar) & frequency 4 Hz every week for one month without operating the machine.

Hva måler studien?

Primære resultatmål

Resultatmål
Tidsramme
Improvement by Scapular Assistance Test and/or Scapular Dyskinesis Test
Tidsramme: 1 month after intervention
1 month after intervention

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. juni 2026

Primær fullføring (Antatt)

1. juli 2026

Studiet fullført (Antatt)

1. juli 2026

Datoer for studieregistrering

Først innsendt

2. juni 2026

Først innsendt som oppfylte QC-kriteriene

2. juni 2026

Først lagt ut (Faktiske)

8. juni 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

10. juni 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

6. juni 2026

Sist bekreftet

1. juni 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Andre studie-ID-numre

  • 36264PR768/7/24

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

JA

IPD-planbeskrivelse

Plan to Share IPD: "Yes" Plan Description: "Data obtained through this study may be provided to qualified researchers with academic interest in scapular dyskinesis. Data or samples shared will be coded, with no PHI included. Approval of the request and execution of all applicable agreements (i.e., a material transfer agreement) are prerequisites to the sharing of data with the requesting party.

Results will be published by the investigators in academic journal.

IPD-delingstidsramme

Data requests can be submitted starting 9 months after article publication and the data will be made accessible for up to 24 months. Extensions will be considered on a case-by-case basis

Tilgangskriterier for IPD-deling

Access to trial IPD can be requested by qualified researchers engaging in independent scientific research and will be provided following review and approval of a research proposal and Statistical Analysis Plan (SAP) and execution of a Data Sharing Agreement (DSA).

IPD-deling Støtteinformasjonstype

  • STUDY_PROTOCOL

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

produkt produsert i og eksportert fra USA

Nei

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